Was COVID a top cause of death for children?

Specifically, in the period August 1, 2021 - July 31, 2022

Jan 31, 2023

Now, you may think this is a strange question, especially since I recently took finalized mortality statistics for the U.S. and gave you ranking tables for 2021:

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Top Causes of Death by Age Group, 2021: Finalized U.S. Stats

Huzzah! The CDC updated WONDER today, which means I’ll be moving forward with all sorts of items I had planned in response. The first is the finalized ranking tables of cause of death for ten-year age groups, which I will give you in absolute counts as well as by rates (in percentages, because most people understand that better…

2 years ago · 6 likes · 1 comment · Mary Pat Campbell

For convenience, I will copy over the lower part of the ranking table here:

We see that COVID goes from the 9th major cause of death up to the 4th, though I am using fairly large age groupings here, reaching into young adults.

To be sure, the number of COVID deaths themselves isn’t that stunning. For the under-age-15 group, that’s only 287 deaths. That total is about the same amount as cancer deaths among 1-4-year-olds in the same period. That’s sad, but hardly fear-inducing for the broader populace.

Hmmm.

Well, maybe somebody can make this sound scarier.

Looking at the Worst 12-Month COVID Period, COVID is Still Only the 8th Highest-Killer of Children

Of course, that’s not how CNN wrote the headline:

Covid-19 is a leading cause of death for children in the US, despite relatively low mortality rate

Covid-19 has become the eighth most common cause of death among children in the United States, according to a study published Monday.
Children are significantly less likely to die from Covid-19 than any other age group – less than 1% of all deaths since the start of the pandemic have been among those younger than 18, according to federal data. Covid-19 has been the third leading cause of death in the broader population.
But it’s rare for children to die for any reason, the researchers wrote, so the burden of Covid-19 is best understood in the context of other pediatric deaths.

It is, isn’t it?

So let’s look at the study itself, shall we?

Study: We tried to get the most severe stats we could

Here is the paper the CNN piece is based on:

Assessment of COVID-19 as the Underlying Cause of Death Among Children and Young People Aged 0 to 19 Years in the US

First, without comment, I will give the key points section:

Key Points
Question Where does COVID-19 rank as an underlying cause of death for children and young people aged 0 to 19 years in the US?
Findings Among children and young people aged 0 to 19 years in the US, COVID-19 ranked eighth among all causes of deaths, fifth in disease-related causes of deaths (excluding unintentional injuries, assault, and suicide), and first in deaths caused by infectious or respiratory diseases. COVID-19 deaths constituted 2% of all causes of death in this age group.
Meaning In this study, COVID-19 posed a significant disease burden for children and young people, so pharmaceutical and nonpharmaceutical interventions continue to be important to limit transmission of the virus and to mitigate severe disease.

Now, with comment, I will take a look at the specific choices made by the researchers in this paper.

First: the period they focused on - August 1, 2021, to July 31, 2022.

That this is a 12-month period is no big deal. You can pick a longer or shorter period if all comparisons are made within such parameters.

But this may be pertinent:

The portion in black is what they’re looking at. Think you know why they want to look at that portion of time rather than a different 12-month period?

Second: the ages included: 0 - 19 — are these fair comparisons for mortality?

This is the portion that really annoys me.

If you have been a longer-term reader of my mortality trends posts, you may have noticed that I generally don’t include “age 0”, that is infants - under age 1 year - in my investigations of childhood mortality trends.

I haven’t addressed infant mortality yet, and the main reason is that it comes with its own set of rankable causes of death completely different from the usual set, and has time measurements completely different (<1 day, 1-6 days, 7-27 days, 28-364 days) — which should give you a hint about how these deaths are distributed. I’m not doing this right now.

But let us go to the paper, because they have it in their own table of top causes of death:

Cause #1 - conditions originating in the perinatal period - almost entirely occurs in infancy. If not infancy, then before age 5.

Cause #3 - congenital malformations, etc. - again, usually causes infant mortality, or early childhood deaths.

And, because the death count is pretty complete for this period by now, here is what the death distribution looks like by age for their chosen period:

And no, that’s not unique to the pandemic. That’s how it usually looks. Maybe you understand why I haven’t written about infant mortality yet.

Ah, but I haven’t marked off which portion of that is officially COVID deaths.

Here you go:

You may start to see the problem, from the point of view of the paper writers, and why they felt like they had to throw in the babies and the young adults with the actual children.

To be fair, I will graph only the COVID deaths so you can see them by themselves:

So now you can see why young adults and infants were included. They could have gotten the ranking they wanted with COVID with just 1-17-year-olds (that is, children), but they would not have gotten the total number of deaths up to something close to 800.

Instead of 829 COVID deaths, which is what I got for ages 0-19 for August 2021 - July 2022, if I had restricted it to ages 1-17 years, which are the ages I look at when I look at child mortality, I would have seen: 476 COVID deaths.

That’s quite a different number.

The age where COVID constituted the highest percentage of deaths for that period was age 9, which is where one finds the lowest mortality rate in general. It was 6% of the deaths. For the other ages, it was about 3% of deaths.

So, it is interesting that at the worst of the pandemic, even for the group where COVID deaths were the highest percentage of deaths, it was only 6% of the deaths. Accidents were still the highest-ranked cause of death in that age group.

Unfortunately, there have been some nasty trends in accidental causes of death, and it seems likely to me that even if COVID attenuates as many infectious diseases do (before they come back again), the accidental causes and similar bad trends are likely to continue.

It may be a good idea to address those, don’t you think?

Also, quit throwing in adults and babies in with the kids to try to make the stats give you what you want.

To answer the original question

Oh, and to answer the title: yes, it was a top ten cause of death for children, where children were defined as age 1-17 years old, for the period Aug 1, 2021 - July 31, 2022, using rankable causes of death for underlying cause of death as defined by the CDC.

In fact, it ranked #6 instead of #8, but only 476 deaths, about the same number as heart disease, which was 455 for the same period.

Here is the CDC WONDER result querying for the top 15 causes: